When Experts Provide Reasonable, Professional and Adverse Opinions ERISA Allows for Reasonable Decision

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After Amy Wright stopped working in 2017, she made two claims with her insurer for benefits that would accrue to her only if she could prove that she was disabled. Ultimately, her plan administrator denied both claims because she did not establish disability. In  Wright v. Reliance Standard , No. 19-14643, USCA, 11TH (January 29, 2021) the court decide only if the decision of the ERISA administrator was Arbitrary & Capricious.

ZALMA OPINION

ERISA allows a great deal of discretion to plan administrators. When, as in Wright’s claim, even her preferred doctors who concluded she was totally disabled repeatedly noted that her gait, range of motion, strength, and many other physical conditions were normal and which contradicted their conclusions and gave strength to the opinions of the administrator’s experts. Since there were good reasons for the administrators decision to reject her claim that decision was neither arbitrary or capricious so the trial court’s decision was affirmed.